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Suicide attempts in bulimia nervosa: Personality and psychopathological correlates

Published online by Cambridge University Press:  16 April 2020

Laura Forcano ,
Fernando Fernández-Aranda ,
Eva Álvarez-Moya ,
Cynthia Bulik ,
Roser Granero ,
Mònica Gratacòs ,
Susana Jiménez-Murcia ,
Isabel Krug ,
Josep M. Mercader  and
Nadine Riesco
...Show all authors
Laura Forcano
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907Barcelona, Spain Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain
Fernando Fernández-Aranda*
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907Barcelona, Spain Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain
Eva Álvarez-Moya
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907Barcelona, Spain Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain
Cynthia Bulik
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Campus Box #7160, Chapel Hill, NC 27599-7160, USA
Roser Granero
Affiliation:
Laboratori d’Estadística Aplicada, Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Spain
Mònica Gratacòs
Affiliation:
Genetic Causes of Disease Group, Genes and Disease Program Center for Genomic Regulation (CRG-UPF), Dr. Aiguader, 88, 08003Barcelona, Spain CIBER en Epidemiología y Salud Pública (CIBERESP), Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader, 88 1a Planta, 08003Barcelona, Spain
Susana Jiménez-Murcia
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907Barcelona, Spain Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain
Isabel Krug
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907Barcelona, Spain Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain
Josep M. Mercader
Affiliation:
Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain
Nadine Riesco
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907Barcelona, Spain
Ester Saus
Affiliation:
Genetic Causes of Disease Group, Genes and Disease Program Center for Genomic Regulation (CRG-UPF), Dr. Aiguader, 88, 08003Barcelona, Spain CIBER en Epidemiología y Salud Pública (CIBERESP), Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader, 88 1a Planta, 08003Barcelona, Spain
Juan José Santamaría
Affiliation:
Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907Barcelona, Spain
Xavier Estivill
Affiliation:
Genetic Causes of Disease Group, Genes and Disease Program Center for Genomic Regulation (CRG-UPF), Dr. Aiguader, 88, 08003Barcelona, Spain CIBER en Epidemiología y Salud Pública (CIBERESP), Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader, 88 1a Planta, 08003Barcelona, Spain Department of Health and Experimental Life Sciences, Pompeu Fabra University (UPF), c/ Dr. Aiguader, 88, 08003Barcelona, Catalonia, Spain
*
*Corresponding author. Department of Psychiatry, University Hospital of Bellvitge, c/Feixa Llarga s/n, 08907 Barcelona, Spain. Tel.: +34 93 2607922; fax: +34 93 2607658. E-mail address: ffernandez@bellvitgehospital.cat (F. Fernandez-Aranda)
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Abstract

Background

Little evidence exists about suicidal acts in eating disorders and its relation with personality. We explored the prevalence of lifetime suicide attempts (SA) in women with bulimia nervosa (BN), and compared eating disorder symptoms, general psychopathology, impulsivity and personality between individuals who had and had not attempted suicide. We also determined the variables that better correlate with of SA.

Method

Five hundred sixty-six BN outpatients (417 BN purging, 47 BN non-purging and 102 subthreshold BN) participated in the study.

Results

Lifetime prevalence of suicide attempts was 26.9%. BN subtype was not associated with lifetime SA (p = 0.36). Suicide attempters exhibited higher rates on eating symptomatology, general psychopathology, impulsive behaviors, more frequent history of childhood obesity and parental alcohol abuse (p < 0.004). Suicide attempters exhibited higher scores on harm avoidance and lower on self-directedness, reward dependence and cooperativeness (p < 0.002). The most strongly correlated variables with SA were: lower education, minimum BMI, previous eating disorder treatment, low self-directedness, and familial history of alcohol abuse (p < 0.006).

Conclusion

Our results support the notion that internalizing personality traits combined with impulsivity may increase the probability of suicidal behaviors in these patients. Future research may increase our understanding of the role of suicidality to work towards rational prevention of suicidal attempts.

Keywords

Eating disordersSuicidal behaviorPredictorsPsychopathologyEating disorder not otherwise specifiedSuicidePsychiatry in EuropePsychometry and assessments in psychiatry
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 2 , March 2009 , pp. 91 - 97
Copyright
Copyright © Elsevier Masson SAS 2009

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